<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <input type="hidden" name="row[type]" value="10">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-title" class="form-control" data-rule="required" name="row[title]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Short_title')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-short_title" class="form-control" data-rule="required" name="row[short_title]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">唯一编号:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-goods_no" class="form-control" data-rule="required" name="row[goods_no]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Image')}:</label>
        <div class="col-xs-12 col-sm-8">
            <div class="input-group">
                <input id="c-image" class="form-control" size="50" name="row[image]" type="text">
                <div class="input-group-addon no-border no-padding">
                    <span><button type="button" id="faupload-image" class="btn btn-danger faupload" data-input-id="c-image" data-mimetype="image/gif,image/jpeg,image/png,image/jpg,image/bmp,image/webp" data-multiple="false" data-preview-id="p-image"><i class="fa fa-upload"></i> {:__('Upload')}</button></span>
                    <span><button type="button" id="fachoose-image" class="btn btn-primary fachoose" data-input-id="c-image" data-mimetype="image/*" data-multiple="false"><i class="fa fa-list"></i> {:__('Choose')}</button></span>
                </div>
                <span class="msg-box n-right" for="c-image"></span>
            </div>
            <ul class="row list-inline faupload-preview" id="p-image"></ul>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Goods_category_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-goods_category_id" multiple data-rule="required" class="form-control selectpicker" name="row[goods_category_id][]">
                {foreach name="goodsCategoryList" item="vo"}
                <optgroup label="{$vo.title|htmlentities}">
                    {foreach name="vo.childlist" item="val"}
                    <option value="{$val.id|htmlentities}" {in name="key" value=""}selected{/in}>{$val.title|htmlentities}</option>
                    {/foreach}
                </optgroup>
                {/foreach}
            </select>
            <!-- <input id="c-goods_category_id"  data-rule="required" data-source="goods/goods_category/index" class="form-control selectpage" name="row[goods_category_id]" type="text" value=""> -->
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Biaoben_type_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-biaoben_type_id"  data-rule="required" class="form-control selectpicker" name="row[biaoben_type_id]">
                {foreach name="biaobentypeList" item="vo"}
                    <option value="{$vo.id|htmlentities}" {in name="key" value=""}selected{/in}>{$vo.title|htmlentities}</option>
                {/foreach}
            </select>
            <!-- <input id="c-biaoben_type_id" data-rule="required" data-source="biaoben/type/index" class="form-control selectpage" name="row[biaoben_type_id]" type="text" value=""> -->
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Biaoben_rongqi_id')}:</label>
        <div class="col-xs-12 col-sm-8">
            <!-- <select id="c-biaoben_rongqi_id" multiple data-rule="required" class="form-control selectpicker" name="row[biaoben_rongqi_id]">
                {foreach name="biaobenrongqiList" item="vo"}
                    <option value="{$vo.id|htmlentities}" {in name="key" value=""}selected{/in}>{$vo.title|htmlentities}</option>
                {/foreach}
            </select> -->
            <input id="c-biaoben_rongqi_id" data-rule="required" data-pagination="true" data-source="goods/biaoben_rongqi/index" data-multiple="true" data-field="title" class="form-control selectpage" name="row[biaoben_rongqi_id]" type="text" value="">
            <!-- <input id="c-biaoben_rongqi_id" data-rule="required" data-source="goods/biaoben_rongqi/all" class="form-control selectpage" name="row[biaoben_rongqi_id]" type="text" value=""> -->
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Num')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-num" class="form-control" data-rule="required" name="row[num]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Keshi')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-keshi" class="form-control" data-rule="required" name="row[keshi]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Fangfa')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-fangfa" class="form-control" data-rule="required" name="row[fangfa]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Time')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-time" class="form-control" data-rule="required" name="row[time]" type="text" value="">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-price" class="form-control" data-rule="required" step="0.01" min="0.01" name="row[price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Original_price')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-original_price" class="form-control" data-rule="required" step="0.01" min="0.01" name="row[original_price]" type="number">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Hospital')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-hospital" class="form-control" name="row[hospital]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Waijian_tags')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-waijian_tags" class="form-control" data-role="tagsinput" name="row[waijian_tags]" type="text">
        </div>
    </div>
    <!-- <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">分佣方式:</label>
        <div class="col-xs-12 col-sm-8">
            <select id="c-commission_type" data-rule="required" class="form-control selectpicker" name="row[commission_type]">
                {foreach name="commissionTypeList" item="vo"}
                    <option value="{$vo.id|htmlentities}" {in name="key" value=""}selected{/in}>{$vo.title|htmlentities}</option>
                {/foreach}
            </select>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">分佣金额:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-commission_price" disabled class="form-control" value="0" step="0.01" min="0" name="row[commission_price]" type="number">
        </div>
    </div> -->
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">临床意义:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-linchuang" class="form-control" rows="5" name="row[linchuang]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Content')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea id="c-content" class="form-control editor" rows="5" name="row[content]" cols="50"></textarea>
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
        </div>
    </div>
</form>